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[All persons without spleen should be given pneumococcal vaccine]
I S Aaberge1, H Nøkleby, L O Frøholm
1Avdeling for vaksine, Statens Institutt for Folkehelse, Oslo.
Insights
Individuals without a spleen face a higher risk of severe infections from encapsulated bacteria like Streptococcus pneumoniae. Vaccination and timely antibiotic use are crucial for preventing pneumococcal sepsis in asplenic patients.
Area of Science:
- Immunology
- Infectious Diseases
- Microbiology
Context:
- Splenectomized individuals are highly susceptible to overwhelming infections.
- Encapsulated bacteria, particularly Streptococcus pneumoniae, pose a significant threat.
- The spleen plays a vital role in clearing these pathogens.
Purpose:
- To outline vaccination and prophylactic strategies for splenectomized individuals.
- To emphasize the importance of monitoring antibody levels and revaccination.
- To recommend early antibiotic intervention for suspected infections.
Summary:
- Splenectomized patients require polyvalent pneumococcal polysaccharide vaccination (PPV) above two years of age.
- Antibody levels should be reassessed 3-5 years post-vaccination, with revaccination for those showing low immunity.
- Prophylactic penicillin V can be prescribed for immediate use pending medical attention.
Impact:
- Improved prevention of severe pneumococcal infections in asplenic populations.
- Reduced morbidity and mortality associated with overwhelming post-splenectomy infection (OPSI).
- Enhanced patient management guidelines for individuals with impaired splenic function.
Abstract:
Splenectomized individuals run increased risk of developing overwhelming septicemia from encapsulated bacteria, especially Streptococcus pneumoniae. Polyvalent pneumococcal polysaccharide vaccine should be given to all splenectomized individuals above two years of age. Antipneumococcal antibody levels should be measured three to five years after the first vaccination, and persons with low antibody levels should be revaccinated. Splenectomized persons may be given a supply of penicillin V to enable them to start therapy while avaiting medical attention.